NHS pioneer Aneurin Bevan would be “spinning in his grave” if he could see the Welsh Government’s record on health, Prime Minister David Cameron claimed today.

Speaking on a visit to Media Wales ahead of May’s council elections, he said he wanted the Welsh Conservatives to be the “party of public service reform”. Mr Cameron also made the firmest statement yet that the electrification of the Valleys rail lines will go ahead, stating: “We are going to do this.”

The UK coalition has been hit by some of its most turbulent weeks following a Budget which triggered accusations of a “raid” on pensioners and strong criticism over its response to the threat of fuel strike.

But the PM was determined to take the fight to First Minister Carwyn Jones’ Welsh Government and singled out education and health for criticism.

He said: “I think Nye Bevan would be pretty upset if he saw what was happening right now, where the UK Government specifically singled out the National Health Service and said ‘We are not going to cut the NHS; we are going to increase investment in out NHS’ but the Labour Government in Wales – a Labour Government – decided to cut the NHS.

"So Wales gets the extra money through the Barnett formula because we’re investing in the NHS in England but it chooses to single out health and cut it by half a billion pounds over the coming years. I think that Nye Bevan would be spinning in his grave if he could see that today."

The Conservative leader defended his right to intervene on subjects for which the Labour Welsh Government is responsible and said it was part of a “respect agenda” between the two administrations.

He said: “I think as Prime Minister of the United Kingdom I have a perfect right to look at what’s happening in terms of education and healthcare and pose some difficult questions. I think that’s a perfect part of the respect agenda.

“Frankly, at the moment, when you’ve got less than half of Welsh children getting five good A-Cs at GCSE, including English and maths, I think parents across Wales will say, ‘You’re right – that’s not good enough. We’ve got to do better’.”

He continued: “There are some difficult things you have to do to raise standards in schools. You’ve need transparency.

“You need to make sure children are regularly tested. You need to make sure you regularly publish results so you can compare one school with another, one year with another, and find out why things are going wrong.”

Insisting he had “no reservations” about criticising the record of another government, he said: “I think when you see standards slipping, as they are in education and healthcare – where since the last election the number of people waiting over half a year for an operation in Wales has almost trebled whereas in England it’s actually gone down by a third – these are real problems.

“Now, I have no reservations in coming to Wales and making some challenging remarks about that because, frankly, I want my party, the Welsh Conservatives, to be the party of public service reform. Because Welsh people deserve better schools, deserve better hospitals.

"There is a centre-right, sensible, Conservative way of doing this which is about choice, competition with the parent and the patient in charge, publishing results, transparency, challenging schools and hospitals to do better – it’s a difficult agenda but it’s the right one if we care about good schools for our children and good hospitals when we get ill.”

Mr Cameron mad the most concrete statement so far about the electrification of the Valleys lines, which supporters claim will bring new economic potential to South Wales.

He said: “It’s in the red book, in the Budget – I mean, we are going to do this. It’s a question of deciding the exact amount of investment that goes ahead and how that is done with the Welsh Assembly Government.

“But be in no doubt, this is firmly on the agenda. It’s not just hints; it’s in black and white in Government documents.”

He defended the push towards the introduction of regional pay, which has sparked concern about the impact in Wales where the Institute for Fiscal Studies has calculated public sector workers earn on average 18% more than those in the private sector.

He said: “I think it’s right to examine issues around regional pay and look at this issue and that’s what the Treasury has promised to do because it can create problems in part of the country if public sector pay is below the levels of private sector pay; it becomes difficult to recruit people into our schools and hospitals.

"And the other way around, if public sector pay runs well ahead of private sector pay, then business when it wants to expand can find it difficult to employ people.

“That’s the reason for looking at this issue.”

The Tory leader also defended changes to the tax credit system which will take effect on Friday and force couples with children to work 24 hours a week – up from 16 hours – in order to qualify for the assistance.

He said: “[I] think what we’re doing is reasonable because if you are a single parent you have to work 16 hours before you can access the tax credit system. So we’re saying to couples: between you, you have to work 24 hours so that’s an additional eight hours between you.

“I don’t think that’s an unreasonable thing to ask people.”

He claimed that “everyone in Wales will see a benefit in terms of paying less in income tax because the personal allowance is being lifted”.

When asked about the future of the Severn Crossing and the potential to come to a new arrangement with the Welsh Government, he said: “There’s a current arrangement which I believe runs out in 2015. We’re very happy to see what the Welsh Assembly Government proposes.”

Defending the Conservative-Liberal Democrat Government’s record in Wales, he said: “I think this is a Government that can come to Wales and hold its head up and say, ‘Of course we’ve had to make some difficult decisions right across the United Kingdom but when it comes to Wales we’ve ticked some of the key boxes we wanted to tick’.”

Next page: David Cameron knows what a crisis looks like

David Williamson: The Prime Minister knows what a crisis looks like

David Cameron knows what a crisis looks like, having been a key aide to Chancellor Norman Lamont in 1993 when Britain dropped out of the ERM with the grace of a cow pushed out the back of an aeroplane.

The experience of watching ministers’ brows furrow did not put him off entering frontline politics – perhaps he gained a taste for the adrenaline which flows in the heat of a crisis?

If so, he must now have enough to fill a score of jerry cans. Days of headlines about taxes on pensioners and pasties, rows over ancient civil liberties, and accusations of incompetence about the handling of the petrol-strike-that-wasn’t have tested his battle armour.

But confidence is one area of life where he has no deficit trouble. And the prospect of a fight with the Welsh Government over Wales’ performance on health and education seemed to produce enough relish to fill a flotilla of hamburgers.

The sight of the red socialist-flavoured water flowing between Wales and England makes his ideological convictions, honed to the point where he won first class honours, bubble and fizz. The argument in Wales, the homeland of Aneurin Bevan and Betsi Cadwalader, comes down to first order issues about how services should be delivered.

Mr Cameron is probably the only Gavin & Stacey fan with access to nuclear missile launch codes. And when he walks into a Media Wales recording studio flanked by the Welsh Secretary and sits down on a red couch to defend his record in Government he gives the sense of a man who feels very much in office and in power – and he likes it.